Healthcare Provider Details

I. General information

NPI: 1619280583
Provider Name (Legal Business Name): RACHEL ANNE FRUGE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2010
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 S PARKER RD
AURORA CO
80014-1623
US

IV. Provider business mailing address

11924 HUMBOLDT DR
NORTHGLENN CO
80233-1218
US

V. Phone/Fax

Practice location:
  • Phone: 303-614-1500
  • Fax:
Mailing address:
  • Phone: 303-452-6802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number194290
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: